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Pemphigoid Gestationis: A Case Report and Review of Literature

Clinical examination revealed the presence of multiple erythematous urticarial plaques topped with tense vesicles and crusted erosions. 2A), and direct immunofluorescence showed linear deposits of C3 at the dermoepidermal junction (Fig. Rapid and sensitive methods are available for the diagnosis of cutaneous herpes in virological laboratories. The blisters typically cluster into groups. PG ordinarily shows amid the second or third trimester with repeat in consequent pregnancies. We describe herein a mother and neonate with HG, with precise weekly follow-up studies of the BP180 NC16a ELISA (BP180 ELISA) index during treatment. – Mild inflammatory infiltrate is noted in the superficial and mid dermis.

It has nothing to do with ordinary Herpes. 2013 Apr 3. There was no crust, scale, or discharge from the rash. An enzyme-linked immunosorbent assay (ELISA) for the PG antibody is now commercially available, and when this highly sensitive test is used, antibody titers appear to correlate with disease activity. An enzyme-linked immunosorbent assay (ELISA) for the PG antibody is now commercially available, and when this highly sensitive test is used, antibody titers appear to correlate with disease activity. My next thought was, “It’s over; I can just be a normal mom.” Sadly, that wasn’t to be, either. Face, scalp, and mucosa were spared.

Therefore, we performed a rapid adrenocorticotropic hormone stimulation test and measured her 24-hour urine cortisol level; on the basis of the test results, she was diagnosed with iatrogenic Cushing’s syndrome. The association or lack of association with atopic dermatitis is debated. We send regular updates to more than 1 lakh suscribers through email and more than 40 thousand suscribers through whatsapp. She was hospitalized and treated with blood transfusion. A 33-year-old primigravida woman in her third trimester of pregnancy presented to the obstetrics department with severe itching. describe some of the major pregnancy-specific skin conditions, which include pruritic urticarial papules and plaques of pregnancy, prurigo of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and pruritic folliculitis of pregnancy. The disease started with a red plaque in the abdominal area accompanied by mild itching.

When healthcare professionals (general practitioners and other specialists) are not aware of this condition, it is likely that the pregnant woman will not be treated appropriately and this will probably lead to a preterm birth and neonatal pemphigoid gestationis. Waar deze klachten vaak niet langer dan enkele weken aanhouden en weinig reden geven tot medisch ingrijpen, bestaan er ook klachten die een stuk ernstiger van aard zijn. Liver function tests were normal, and results of direct and indirect immunofluorescence staining of a skin biopsy were negative. A 36-year-old woman at 24-weeks gestation presented to New York University Dermatologic Associates in July, 2009, with a widespread, pruritic eruption. The final diagnosis was 30 weeks pregnant women with gestational herpes complicated by pyogenic infection of the lesions, discarding infection with HIV and found positive for IgG to toxoplasma, rubella, cytomegalovirus and herpes virus. Other exogenous factors may affect the development of these autoantibodies in a population without clinically evident immunobullous disease, including limitations inherent to the test (false-positive rate). The patient with pemphigoid gestationis was subsequently treated with systemic corticosteroids until the symptoms of her self-limited disease ceased.

Discussion: Demographic and clinical findings, such as median age, sites of involvement, and gestational age of onset or C3 of our patients, coincide with those described in previous reports. Newer lesions started developing in the subsequent days and she was referred to our hospital. PG appears to be caused by an anti-BMZ antibody that induces C3 deposition along the dermal-epidermal junction. Target antigens of the autoantibodies in BP patient serum are BP230 and BP180 also called BPAG1 and BPAG2. The clinical, histologic, and immunopathological features of pemphigoid gestationis are similar to those of the pemphigoid group of disorders. PG appears to be mediated by a specific immunoglobulin G (IgG) directed against the cutaneous basement membrane zone (BMZ). It usually occurs during the second or third trimester, but it may be present at any stage of pregnancy or the puerperium.

3Graduate in the Dermatology Department, Portuguese Oncology Institute of Coimbra – Coimbra, Portugal. The serum was also negative for circulating antibody to basement membrane of skin. The physical examination revealed urticarial, eczematous plaques with erosive and crusted blisters on her arms, chest, back, and abdomen (Figures 1 and 2). Maternal and fetal outcomes are not affected. Fluorescence type and antibody titre are evaluated. Pemphigoid gestationis (PG), first described in 1872 by Laws Milton, is a rare autoimmune bullous disease of pregnancy and puerperium. [1] IgG autoantibodies in HG bind to the 16 th noncollagenous domain (NC16a) of bullous pemphigoid antigen 180 (BP180), which is also recognized by bullous pemphigoid (BP).